Friday, February 22, 2013

Breast Hiding Spot

The intermittent sound of the bipap alarm was a little annoying...  all I wanted to say was "leave the damn mask on", but I understand that the mask can be uncomfortable.  Her lungs were crappy, without bipap her pulse ox was in the high 80's.  I called respiratory and they fitted her with a new mask.  She said it felt better and agreed to leave it on.

Her lungs weren't her only problem.  This rotund lady also had a glucose level 750 and it wasn't budging even though she was on an insulin drip and getting hourly boluses of insulin.  She was in DKA. 

About twenty minutes after the bipap mask was changed, I heard the alarm go off, but it stopped by the time I got to the curtain.  I heard the patient rustling in her bed and again the alarm went off and then abruptly it stopped.  As I walked in the room to check her glucose level she quickly moved something.  I thought  it was a cell phone.  I opened the top of the case that held the fingerstick machine and managed to drop a few alcohol wipes on the floor.  As I bent over to pick them  up I saw a bunch of Starburst candy wrappers on the floor.  

I picked them up placed them on her bed so she could see them and then did her fingerstick it was again over 500.

"Okay", I said, "Hand it over." 
She looked at me, with the surprised guilty look that puppies have on their face when they eat their mommy's shoes. 
"I don't got nothing", she said. 

I looked at the cardiac monitor and her pulse jumped up a bit.  I knew she was hiding her stash somewhere and she didn't have many places to hide it.  She didn't have a purse or a table within reach to put it in.  

So I thought to myself where could it be.  

I then decided that I should reassess her lungs and check her monitor leads, as well as the edema in her legs.  

She leaned forward so I could listen to her lungs which still sounded crappy, and there was no sign of starbursts.  I then listened to the front of her chest, and after lifting up her large pendulous breast I found the mother load of candy.  Two packs of Starbursts and a melted chocolate bar still in the wrapper.  

Over the course of the next few hours her glucose level came down and her labs improved.  

Till this day I still can't eat Starbursts!






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